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TECHOAT-01
<br />KHARATSJ
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIYyYY)
<br />1/31/2017
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement oil
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />COMTACT
<br />POLICY EXPLTR
<br />Willis of Florida, Inc.
<br />c/o 26 Carl Bivd
<br />P.O. Box 305991
<br />PHONE
<br />lac,
<br />FAX
<br />Nn, r (877) 945-7378 AIC, N.):(888) 467-2378
<br />e�AIL .certificates@willis.eom
<br />Nashville, TN 37230.5191
<br />INSURERS AFFORDING COVERAGE
<br />ZIII'Ich American Insurance Company 16535 _.
<br />_._...._
<br />___..._..INSur
<br />INSURED
<br />INSURER B: American Guarantee and Liability Insurance Company 26247
<br />INSURER C: American Zurich Insurance Company _ 40142
<br />Tech Data Corporation D/B/A Signature Technology Group
<br />INSURER D: Hiscox Insurance Company Inc. 10200
<br />.._
<br />5350 Tech Data Drive
<br />Clearwater, FL 33760
<br />Travelers Casualty and Sure Company of America
<br />E: Y Surety P Y 31194
<br />_
<br />iINSURER
<br />INSURERF,�
<br />f`nVPn AGPIC PPOTIPIPATP MI111,10 P. ocVr¢rmo unsaovo.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE. BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE OF INSURANCE
<br />AINSD DDL
<br />SUBR
<br />POLICY NUMBER
<br />PO/ICCYEFF
<br />POLICY EXPLTR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCURX
<br />GL03878469-09
<br />02/01/2017
<br />02/01/2018
<br />_
<br />EACH OCCURRENCE 1,DOO,000
<br />DAMAGE TO REoccoante - 1,000,000
<br />_
<br />MEDEXP ArIone erson $ 10,000
<br />PERSONAL B ADV INJURY_- 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY ❑ j,COT- 1XI LOC
<br />GENERAL AGGREGATE $ 2'000'000
<br />GEN'L
<br />PRODUCTS-COMPIOPAGG 2,000,000
<br />OTHER
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBzB tlED SINGLE LIMIT 1,000,000
<br />nt
<br />BODILY INJURY (Per arson
<br />X
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BAP3878470-09
<br />02/01/2017
<br />02/01/2018
<br />BODILY INJURY Paraealmmo $
<br />X
<br />AUTOS ONLY X AUTNOS ONLY
<br />P�2OPERa1" AMA MA E $
<br />ar accl ant
<br />B
<br />X
<br />UMBRELLA LIAB
<br />�1
<br />OCCUR
<br />EACH OCCUR_RE_NCE 51000'000
<br />v
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />AUC5344130-12
<br />02/0112017
<br />02/01/2018
<br />AGGREGATE 5,000'000
<br />DECX7 RETENTION $ 0
<br />C
<br />WORKERS COMPENSATIONAND
<br />MYPROLOYERS'LIAaaIW
<br />OFFICE PRIETOR/PARTNER/EXECUTIVE YIN
<br />(Mmdaj%ilMBER EXCWDEp9
<br />(Mantlatory in NH)
<br />If yes, describe under
<br />DESCRIPTIONOFOPERATIONSbelow
<br />N(A
<br />WC3878467-09
<br />02/0112017
<br />02/01/2018
<br />pTH-
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />EL DISEASE -EA. E PLOYEE 1'000,000
<br />E. L. DISEASE_-POLICYLIMIT $ 1,000,000
<br />D
<br />Errors & Omissions
<br />UCS2707738.16
<br />06/0112016
<br />06/01/2017
<br />Limits: 5,000,000
<br />E
<br />Crime -
<br />105888443
<br />02/0112016
<br />02101/2018
<br />See Attached
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101,Additlonal Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as an Additional Insured as respects to General Liability,
<br />City of Santa Ana
<br />Attn: Lynda Kelly
<br />20 Civic Center Plaza M-12„�l),..Q V Ut
<br />ISanta Ana. CA 92701
<br />ACORD 25 (2016103) L Yvm'L,� 2
<br />The ACORD name and logo are
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />©1988.2015 ACORD CORPORATION. All rights reserved.
<br />v qis ered marks of ACORD
<br />
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